Association between physical inactivity and headache disorders

In a cross-sectional analysis of the ELSA-Brasil cohort, consisting of more than 15,000 civil servants, physical inactivity was associated with headache disorders [1]. Distinct associations were found regarding sex, physical activity domain and intensity, headache subtype, and attack frequency.

Previous studies have shown that physical inactivity is associated with a higher prevalence of primary headache disorders, particularly migraine. However, heterogeneous associations regarding sex, headache subtype, physical activity intensity, and headache attack frequency have been reported. In addition, no validated questionnaires on physical activity nor standardised definitions of physical activity have been used. Most studies investigated physical activity levels in leisure time and none in commuting time. The current cross-sectional analysis of the ELSA-Brasil cohort aimed to implement all guidelines.

Almost all 15,000 participants (54.4% women) provided data on physical activity levels and headache. Dr Arão Oliveira (University of São Paulo, Brazil) presented the data. The 1-year crude headache prevalence was 70.4%, with migraine present in 8.4% of respondents. Overall, participants with headache disorders were younger and had higher socioeconomic status.

People with (probable) migraine had a lower cardiovascular risk profile, were more physically inactive compared with the ‘no headache’ group, and had a higher attack frequency compared with persons with other headache disorders, such as tension-type headache (TTH). People with TTH showed less physical activity in the commuting time.

In the adjusted models, physical inactivity in leisure time was associated with a higher prevalence of definite migraine (OR 1.32) and probable migraine (OR 1.33) in the whole cohort. Sex differences were observed, with OR 1.20 for definite and OR 1.29 for probable migraine in women, whereas in men, it was only associated with probable migraine (OR 1.40). Physical inactivity in the commuting time also showed a sex difference: in men, it was associated with probable TTH (OR 1.33); in women, it was inversely associated with definite migraine (OR 0.79) and probable migraine (OR 0.80).

By evaluating the intensity of physical activity, the researchers found that vigorous inactivity in leisure time was associated both with definite migraine (OR 1.36) and probable migraine (OR 1.37). There was a strong linear trend for the association between physical inactivity and headache attack frequency (P-value for trend <0.001). These findings have implications on tailoring the prescriptions of physical activity in people with headache disorders.

1. Oliveira AB, et al. Physical inactivity and headache disorders in the ELSA-Brasil cohort: A cross-sectional analysis. AL017, IHC 2021, 8–12 September.

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Posted on 8 November 2021